Meta-analysis finds nearly half of Ethiopian glaucoma patients report poor quality of life

INTRODUCTION: Glaucoma is a leading cause of irreversible blindness worldwide, with profound physical and psychosocial effects. In Ethiopia, limited access to specialized eye care, delayed diagnosis, and low awareness exacerbate its impact on patients' quality of life. This review aimed to synthesize existing evidence on the prevalence and determinants of poor QoL among glaucoma patients in Ethiopia. METHODS: Following the PRISMA 2020 guidelines, a systematic search was conducted across PubMed, Scopus, Web of Science, CINAHL, and Google Scholar up to March 2025 (PROSPERO: CRD420251018342). Eligible studies assessed QoL among adult glaucoma patients in Ethiopia using standardized instruments. Methodological quality was appraised using the Joanna Briggs Institute checklist, and a random-effects model was applied to estimate pooled prevalence. Heterogeneity was evaluated with I statistics, and certainty of evidence was assessed using the GRADE framework. RESULTS: Four hospital-based studies met the inclusion criteria. Three NEI-VFQ-25 studies were meta-analyzed, yielding a pooled prevalence of 47% (95% CI: 44-50; I = 19.6%). One additional WHOQOL-BREF study, which was not pooled because of tool heterogeneity, reported a comparable prevalence of 46.3%. Factors consistently associated with poorer QoL included older age, rural residence, low education, economic hardship, limited healthcare access, disease severity, and psychological distress. CONCLUSION AND RECOMMENDATIONS: Nearly half of Ethiopian glaucoma patients experience impaired QoL. The certainty of this evidence is low to very low due to cross-sectional study designs and limited representativeness. Strengthening early detection, equitable access to eye care, patient education, and psychosocial support is essential, while community-based longitudinal studies are needed to generate higher-quality evidence.